Opioid, heroin overdoses reach 'crisis level' in Md.

Overdoses now rank with cancer, strokes and heart attacks among the top killers in the state

By Jess Nocera
Associated Press

WASHINGTON — When Carin Miller's son was about 19 years old, he began to abuse heroin by snorting pills, eventually moving on to shooting up. This went on for six years before he got help.

Lucas Miller's history of drug use started in high school with smoking marijuana. When he moved out of his parents' house, one of his housemates had access to between 750 to 1,500 pills at any given time between five houses located in Frederick, Maryland.

The Maryland General Assembly passed several bills to address the ongoing statewide crisis. (AP Photo)

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"My son was addicted to heroin, he's in recovery by the grace of God since Thanksgiving 2014, I think that's where we are at," Miller said.

Opioid overdoses now rank with cancer, strokes and heart attacks among the top killers in Maryland.

State and federal lawmakers have passed legislation aimed at addressing the crisis, although they and public health experts agree the battle will be long.

On April 10, the Maryland General Assembly passed several bills to address this ongoing statewide crisis. The Start Talking Maryland Act, HB1082, and the HOPE Act, HB1329, were both passed.

The HOPE Act would increase access to naloxone, an overdose-reversal drug and would require hospitals to establish a new protocol when discharging patients treated for substance abuse disorders. It also introduced Keep the Door Open, a provision that provides three years of funding to reimburse community health providers. The act also requires the Behavioral Health Administration to establish a crisis treatment center before June 2018.

The Start Talking Maryland Act would require schools to have defined education programs on opioid addiction.

Other opioid related bills passed by the General Assembly were HB1432, which places a restriction on the number of opioid painkillers a doctor can prescribe to a patient per visit, and SB539, a bill that sets new penalties for distributing fentanyl.

The opioid-related legislation has been sent to Maryland Gov. Larry Hogan's desk for his signature. The governor has until May 30 to either sign or veto the 900 bills passed by the General Assembly; otherwise they automatically become law.

On March 1, Hogan signed an executive order, declaring a state of emergency in response to the heroin, opioids and fentanyl crisis "ravaging communities in Maryland and across the country."

"We need to treat this crisis the exact same way we would treat any other state emergency," Hogan said in a statement. "This is about taking an all-hands-on-deck approach so that together we can save the lives of thousands of Marylanders."

The final numbers for 2016 are expected to show that approximately 2,000 people died from heroin and other opioid overdoses in the state over the last year, about double the number of deaths in 2015.

Additionally, drug overdose deaths rose by 19.2 percent from 2013 to 2014 in Maryland, according to a press release from Sen. Ben Cardin, D-Md.

"There's no question, no question there has been a spike in opioid overdoses," Cardin said in an interview with Capital News Service. "Let me indicate the numbers in Maryland are shocking as we are seeing the doubling and tripling over the last couple of years, but the Maryland numbers are typical to what we see all over the country."

Both Cardin and Sen. Chris Van Hollen backed passage of the 21st Century Cures Act and the Comprehensive Addiction and Recovery Act of 2015 (CARA). Van Hollen was a cosponsor for the 21st Century Cures Act.

"The opioid addiction epidemic is having a devastating impact on communities in Maryland and across the country," Van Hollen said in a statement for Capital News Service. "I fought to pass the 21st Century Cures Act, which helps states expand programs to treat those suffering from addiction, but we must do much more to prevent substance abuse and to get help to those who need it."

The 21st Century Cures Act was signed by President Barack Obama in December. It will provide $1 billion over two years for state grants to support opioid abuse prevention and treatment activities. CARA, a bipartisan bill, was signed into law by Obama last July. CARA assists drug-dependent newborns and their parents.

The federal Department of Health and Human Services has just awarded Maryland a $10 million grant under the 21st Century Cures Act.

"These grants are a small but encouraging step toward addressing the opioid crisis," Rep. John Sarbanes, D-Towson, said in a statement. He was among those who pressed for the funds in the law. "But to make real progress in our effort to combat the epidemic, it's the responsibility of Congress to provide additional resources to programs, families and communities in Maryland and across America that are working day in and day out to end the crisis."

Van Hollen said there is more to be done with the crisis, including "protecting the significant investments made by the Affordable Care Act, and ensuring institutions like the National Institute for Drug Abuse at NIH in Maryland and others across the country have the resources necessary to carry out their critical missions."

On March 29, President Donald Trump signed an executive order creating a presidential commission designed to combat opioid addiction and the opioid crisis nationwide. New Jersey Gov. Chris Christie is leading the commission.

A main reason for the doubling of overdoses for Maryland has been a new street drug, fentanyl, a powerful synthetic opioid that dealers are increasingly blending into regular heroin and selling cheaply.

Fentanyl is coming to the United States from China, and that needs to be stopped, Cardin said. The senator added that there also is work to be done with Mexico to stop heroin from flowing from that country.

"We've seen an abuse of using these drugs for pain and an abuse of people selling these drugs on the street and getting people addicted," Cardin said. "There are things we can do to dry up the supply and help people who have addiction and health issues."

In response to the rise in drug-related deaths, Hogan announced on March 1 that he has budgeted an additional $10 million per year to combat overdoses over the next five years.

Miller said Hogan's action would help, but more money is needed from the federal government.

Miller is no stranger to opioid abuse as well. She said her husband, Greg Miller, had been abusing opioids since the late 1990s after he was hit by a drunk driver and had an additional, separate accident at work.

It reached a point where her husband's withdrawals were so terrible that he almost died after being denied narcotics prescriptions at Frederick Memorial Hospital six years ago, Miller said.

"I was trying to get my husband off the pills, never thinking that my own kids would go on them after they saw the hell that I was put through," Miller said.

Three years ago, Miller co-founded Maryland Heroin Awareness Advocates (MHAA), a grassroots organization in Frederick. It was founded "out of necessity," by a group of women from Frederick in order to save their children from the opioid and heroin epidemic, Miller said.

"We have all been affected in some way, a lot of my colleagues have lost their children to overdoses," said Miller, who is the president of MHAA.

Miller noted that there is not enough education about these drugs in schools. While one of her colleagues is invited into middle and high schools in Carroll County to give presentations, MHAA is "just nipping the bud" at giving presentations in Frederick County, Miller said.

Frederick County is a 40,000-student district with 10 high schools.

"We really give the principals the autonomy to address any issue in their community," said Mike Maroke, Frederick County Public Schools deputy superintendent. "They determine if this is something be address or not."

If the Start Talking Maryland Act is signed by Hogan, it would require schools to have opioid education programs, possibly through presentations such as MHAA's.

After one presentation at a school, Miller handed out index cards to the students, ranging from seventh to twelfth grades, and asked for their feedback. She recalled what happened next: "One little girl came up to me and handed me her card and it said 'Thank you for coming out and telling us about drugs because I wouldn't want to lose any friends because my dad died a couple of months ago from a heroin overdose.'"

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